Severe allergies and anaphylaxis

by Abdullah Arif · July 1, 2024

What do a peanut, a wasp, and penicillin have in common? All three can trigger a serious allergic reaction that requires immediate medical attention, such as anaphylaxis. Would you be prepared to respond to such a reaction?

ANAPHYLAXIS: WHAT IS IT?

A severe allergy, or anaphylaxis, is an abnormal response of the immune system to the presence of a trigger. Also called an allergen , this trigger is perceived (wrongly, most often) as undesirable and dangerous by the immune system, which then releases chemical substances to protect the body against this “threat”. This triggers a disproportionate and generalized reaction which affects several systems of the body, progresses quickly and can even be fatal in the most serious forms.

SIGNS AND SYMPTOMS OF ANAPHYLAXIS INCLUDE:

generalized redness of the skin often accompanied by significant itching;
a metallic taste or itching in the mouth;
swelling of the throat, lips and tongue,
which may lead to difficulty speaking or breathing;
a sudden drop in blood pressure accompanied by an increase in heart rate;
paleness and a sudden feeling of weakness;
dizziness and loss of consciousness.

Symptoms can occur within minutes or hours after exposure to an allergen. In a very short time, the reaction can become potentially fatal. It sometimes occurs in two stages, with a second reaction possibly appearing up to 36 hours after the first.

WHAT ARE THE TRIGGERING FACTORS?

Many substances can trigger allergic reactions, but severe allergies are most commonly caused by:

foods or food substances or additives: peanuts, tree nuts, milk, soy, eggs, sesame, fish, seafood, wheat, mustard, gluten, lactose, sulphites or food colorings;
medications: beta-lactam antibiotics (including penicillin), intravenous anesthetics, opioid analgesics (morphine and its derivatives), aspirin and nonsteroidal anti-inflammatory drugs;
insect stings and bites (bees, wasps, hornets and certain ants);
latex; And
physical exercise.

However, the cause of the serious allergic reaction may not be determined. This is called an idiopathic anaphylaxis reaction .

HOW TO PREVENT ANAPHYLAXIS?

No medication or medical treatment can cure an allergy. The only possible way to avoid serious allergic reactions is to eliminate all exposure to the problem allergen. And it’s not easy! On the other hand, everything must be put in place to achieve this goal.

To do this, we must always carefully check the labeling of foods, cosmetics, supplements as well as natural and homeopathic products. It is important to always notify health professionals, especially your pharmacist, of an allergy to a medication or one of its components.

WHAT TO DO IN CASE OF ANAPHYLAXIS?

In the event of a severe allergic reaction, it is important to act quickly. Epinephrine is the first-line treatment that counteracts anaphylaxis. It is sold in an auto-injector pen designed to make it easier to administer. Epinephrine should be used immediately after exposure to an allergen, as soon as symptoms appear or before if you are certain you have been exposed. Afterwards, you should go to the nearest emergency department without delay. The medical team will then take charge of the patient for the next steps.

SOME TIPS AND ADVICE

When you have a severe allergy or are at risk of anaphylaxis, it is important to:

to inform those around you of the allergy, including school or daycare staff if it concerns a child;
to wear a bracelet, pendant or anything else indicating the allergy;
to always have an epinephrine auto-injector pen on hand and to store a few in different locations;
to occasionally reread the instructions for use so that you are able to use the auto-injector pen quickly if necessary, without hesitation. It may be a good idea, from time to time, to watch a demonstration video on the product manufacturer’s website;
to ensure that those around you know how to use the auto-injector pen;
to regularly check the expiration date of the epinephrine and to always store the auto-injector pen within the temperature range recommended by the manufacturer (most often between 15 and 30°C);
never store the auto-injector pen in a place subject to extreme temperatures, such as a car;
to replace the auto-injector pen when the epinephrine has passed its expiration date. Your pharmacist can remind you to do this. Ask them for more information about this service.

Anaphylaxis is a medical emergency. When it occurs, you must act very quickly. If you are the parent of a child with a severe allergy, you must have sharp reflexes. Your pharmacist can be a valuable ally in managing a severe allergy. If in doubt, consult them. Your child’s safety depends on it!